Louisiana, New Orleans Katrina Victims Need Mental Health Services

Anyone who read Chris Rose’s account of his battle with depression in post-Katrina New Orleans is not likely to forget it. The Times-Picayune journalist described in spellbinding detail each facet of the illness that silently consumed his life: the mind-numbing trauma of reliving and writing about the destruction of his beloved city, the debilitating sense of alienation that made even the most casual social contact unbearable, and the incomparable sense of unreality that manifested as ‘the thousand yard stare’.

Multitudes of Katrina survivors know exactly what Rose is talking about. Yet the well-documented local increases in depression and anxiety have not been met with an increase in services. It is a bitter irony that, at a time when the need for mental health care in Louisiana has never been greater, services have been downsized to a fraction of pre-storm levels. Thus, there is growing support for mental health care to be included as an integral part of any major disaster relief process.

Last week on November 8 and 9, experts in the field of disaster-related mental illness gathered in Atlanta at the 22nd Annual Rosalynn Carter Symposium on Mental Health Policy to discuss the psychological consequences of hurricane Katrina. The Carter Center was founded in 1982 by former US President Jimmy Carter and the former First Lady, and its mission includes advancing human rights and alleviating human suffering. The Katrina symposium featured presentations, work groups and panel discussions that debated ways to improve disaster planning, preparedness, and response in order to recognize the mental health implications for disasters survivors.

“People in New Orleans and evacuees who moved to other areas around the country are still suffering from the trauma of Hurricane Katrina,” said Mrs. Carter.  “Our goal is to use the lessons learned from that catastrophic event to improve the mental health outcomes for people affected in the next disaster.”

The event was co-hosted by Dr. Thom Bornemann, who helped organize mental health professionals in response to hurricane Katrina. He said, “The impact of Hurricane Katrina on victims was unprecedented for our nation. People suffered multiple traumas not only from injury and loss of possessions, but from the perception that agencies and authorities were unable or unwilling to help them.”

One study on Katrina survivors published in the Bulletin of the World Health Organization found that mental health problems in Katrina-affected areas roughly doubled after the hurricane, with 11.3 percent of respondents suffering serious mental illness. A further 19.9 percent reported mild to moderate mental illness. The report also noted that the survey was limited to Katrina survivors in Louisiana, Mississippi and Alabama, and there is no similar data available for residents who were displaced to other areas of the country. It seems safe to say that the impact of being separated from one’s community and social support network is likely to exacerbate any mental illness, and thus further research is warranted.

An earlier study estimated that 25 percent of households affected by hurricanes Katrina and Rita in Orleans and Jefferson Parishes contained one or more members in need of counselling services, but only 1.6 percent contained a person who had received counselling services by October 2005.

At a time when the local need for mental health services is obviously outstripping supply, there is no sign that the federal government appreciates the urgency for Katrina survivors. In September, the Times-Picayune revealed the federal government’s shocking disregard for community health clinics who provided mental health care to people on Medicare or Medicaid while their certifications were pending. A spokesman for the Centers for Medicare and Medicaid Services commented that local clinics who had applied for certification had to wait their turn until inspectors were already scheduled to travel to the area. He also confirmed that the federal government would not reimburse clinics who had provided services to Medicare/Medicaid patients prior to certification, and proposed that the clinics who had cared for these patients would need to take responsibility for their ‘business’ decisions.

Meanwhile, there are scores of working people in Louisiana who either can’t afford health insurance, or whose insurance policies don’t cover mental illness. They are left to cope with untreated depression and anxiety while they process the enormity of their losses, hold down their jobs, take care of their loved ones and rebuild their city. This does not seem tenable and makes a compelling case for mental health care to be provided for survivors as part of any major disaster relief process.

Following the Katrina symposium on mental health, the Carter Center will now collate the results, recommendations and action plan developed by participants. These will be distributed to individuals, organizations and policy makers involved in mental health and disaster response.

These policy recommendations could well find their way to the US Congress, where there is talk of a more rigorous inquiry into the federal government’s response to Katrina. It would be a solid, positive outcome if the lessons of Katrina were truly learned and government responses were improved to respect and address the enormous psychological suffering of disaster survivors.


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